ADAI-IB 2013-02

INFO Brief
Heroin Tr ends Across Washington State
June 2013
Washington, like much of the United States, has seen increases in the use and harms associated with heroin. Because direct measurement of heroin use is difficult, various indicator data are used instead. Police evidence provide a close to real time picture of what is
available on the street. Treatment data tend to lag behind heroin availability and onset of use by several years. Deaths are a lagging
indicator as well, though King County data show an increase in deaths involving heroin among those under 30 in 2012, indicating that
the lag may not be as long as expected. The rate of all opiate deaths (heroin and/or Rx-type) has nearly doubled in the past decade.
For some, abuse of prescription-type opiates (e.g. morphine, oxycodone, methadone) leads to heroin use* so preventing inappropriate
use of prescription (Rx) opiates is important. All opiate overdoses can be prevented and most can be reversed before they become fatal. This report summarizes the most recent data available for heroin and includes information about resources to help people prevent
and treat opiate addiction and prevent fatal overdoses.

Police evidence tested by the State Crime Lab

The past decade has seen an overall decline in the amount of
evidence sent to the state crime lab for testing. Heroin and Rxtype opiates are the exception. Rx-type opiates peaked in 2009
while heroin increased. These data parallel the impressions of
police across much of the state that heroin has increased in local
communities in recent years.

Heroin in police evidence

annual average 2001-2002

Heroin in police evidence

annual average 2011-2012

Trends in the use of Rx-type opiates to get high among 10th graders and the association with heroin use
The proportion of 10th graders reporting use of Rx-type
opiates to get high in the past month declined in 2012.
Past month use of Rx-type opiate to get high

Among those who had used Rx-type opiates to get high in the past
month 23% had ever used heroin, compared to 3% among those who
had not used Rx-type opiates to get high in the past month.
Past month use of Rx-type opiate to get high in 2012 & ever used heroin

Treatment admissions
Total treatment admissions show that heroin is the most common drug in 2012 among 18-29 year olds. First time admissions to
treatment indicate that the growth in heroin admissions is driven by young adults and is primarily outside of the Seattle metro area.

Total treatment admission trends ages 18-29 (1999-2012)

First time in treatment, heroin primary drug

First time in treatment, heroin primary drug 2012

First time in treatment, heroin primary drug 2003

Fatal overdoses involving heroin and/or Rx-type opiates (unintentional)

The average annual number of deaths from 2000-2002 was 310, from 2009-2011 it was 607. The majority of deaths involved Rx-type
opiates from 2000-2011. Heroin and unspecified opiates increased in the period from 2009-2011. King County data for 2012 indicate 84
heroin involved deaths, up from 49 in 2009, with all of the increase among those under 30 (data not shown).
# of deaths

2009-2011

2000-2002

Infectious diseases can be spread via injection drug use

Chronic hepatitis C infection diagnosis rate 2009-2011

Washington state has a low prevalence and incidence of HIV among injection drug users (IDU) which is related to our longtime and widespread syringe exchange programs dating back to 1988. Hepatitis B and C can be
spread more easily than HIV via injection drug use. In King County 75% of
IDUs have Hepatitis C. Hepatitis C diagnoses from 2009-2011 indicate that
some of the highest rates are also in counties where heroin indicators are
the highest; however, current data on risk factors related to hepatitis infection are unavailable.

Resources

Data sources

How to prevent and reverse overdoses:

http://stopoverdose.org

Police evidence tested by State lab Data source: WA State Patrol, Forensic Lab Services Bureau,

Safe opiate medication usage:

http://takeasdirected.doh.wa.gov/

10th graders Rx-type opiate and heroin use Health Youth Survey; Fatal opioid overdoses; Hepatitis C
diagnosis rates- WA State Dept of Health
Treatment admissions (publicly funded) WA State DSHS, Div. of Behavioral Health & Recovery

Syringe exchange programs in WA:

http://nasen.org/programs/us/wa/

Fatal overdoses involving heroin King County Medical Examiner, Public Health Seattle & King County

Drug treatment information:

www.dshs.wa.gov/DBHR/

Hepatitis C prevalence in King County Public Health Seattle & King County. HIV/AIDS Epidemiology
Report, First Half 2012: Volume 80.

Additional drug trends data:

http://adai.washington.edu

*Peavy et al. (2012)"Hooked on" prescription-type opiates prior to using heroin: results from a survey
of syringe exchange clients. http://www.ncbi.nlm.nih.gov/pubmed/23061326

Data tables
Rates, presented in maps, represent counts per 100,000 population. Tables below are sorted from highest to lowest rate for the most current year of
data available. The absolute ranking should not be over-interpreted, particularly when the absolute numbers are relatively small, e.g. less than 5.

Police evidence testing positive for heroin

Opioid related deaths by residence county

Chronic hepatitis C virus diagnosis rate per

100,000 2009-2011

Citation: Heroin Trends Across WA State. (ADAI Info Brief). Prepared by Caleb Banta-Green, PhD, MPH, MSW, for the UW Alcohol & Drug Abuse
Institute, June 2013. URL: http://adai.uw.edu/pubs/InfoBriefs/ADAI-IB-2013-02.pdf. Supplemental data: Police evidence positive for Rx type
opiates by county of law enforcement jurisdiction. http://adai.uw.edu/pubs/InfoBriefs/ADAI-IB-2013-02_suppl.xlsx